Disaster Medicine and Public Health Preparedness最新文献

On September 17, 2024, at 15:30 local time, thousands of pagers used by members of a specific party group detonated across Lebanon. As a result of the explosions, 2800 were wounded and 12 lost their lives. Almost two-thirds of the injuries were in the face, eyes, or hands. The Lebanese American University Medical Center received 38 injured and admitted 36 patients, 13 of them to the Intensive care unit. A total of 33 patients needed surgeries. All medical and nursing staff were deployed. The health care workers faced major challenges that night: the severity of the injuries and the unprecedented types of injuries with the same pattern, and the urgent need for ophthalmology and orthopedics within the hospital and across the country. Learning from the Pager Explosion, each hospital should perform assessments of their disaster response plan, develop trainings, and conduct regular exercises in preparation for future disasters.

Objective: The COVID-19 pandemic is a disaster event. Exposure to stressors during and after disaster events is associated with negative mental health symptoms. To inform targeted COVID-19 recovery efforts, data are needed to understand which stressors play a key role in this relationship.

Methods: Cross-sectional survey data (demographics, impacts of COVID-19, social determinants of health, depression, and anxiety) were collected online from adults living in New York state between May and June 2020. Differences in the proportion of stressors (COVID-19 and social determinants) experienced by race/ethnicity were assessed using chi-square analyses. Logistic regression was used to assess which factors were associated with increased odds of depression and anxiety.

Results: A majority (n = 258, 62.2%) of the 415 respondents reported being directly impacted by the pandemic. Non-white respondents reported a significantly larger proportion of stressors compared to white respondents. Under half of respondents reported depression (n = 171, 41.2%) and anxiety (n = 164, 39.5%). Healthcare and food concerns were associated with increased odds of depression and anxiety, and economic concerns were associated with increased odds of anxiety.

Conclusions: Findings underscore the need to respond to the COVID-19 mental health crisis by addressing social determinants of health.

Objective: Integration of head-mounted virtual reality (VR) devices has been revolutionary in health professions education. In disaster preparedness training, VR simulation-based learning exposes health care professionals to the unique challenges of diverse scenarios, enhancing their adaptability. The aim of the study was to evaluate the effectiveness of a head-mounted VR tool for teaching basic radiation emergency medicine skills to medical students.

Methods: The participants were 64 medical students (5th-year) who underwent a 3-hour training session in radiation emergency medicine that was conducted via head-mounted VR devices. Students scored their perceived emotion, performance, and self-efficacy at various time points in a self-reported online questionnaire.

Results: Comparison of survey responses before and after the session showed significant differences in terms of neutral emotion (P = 0.011), negative activating emotions (P < 0.001), and negative deactivating emotions (P = 0.004). The post-hoc test revealed statistically significant differences in negative activating emotions between before and during (P < 0.05), and between before and after (P < 0.05) the VR simulation. In addition, negative deactivation and neutral emotions changed significantly after the simulation.

Conclusions: The use of head-mounted VR devices was effective in modulating medical students' emotions and contributed to improving their perceived performance in radiation emergency medicine.

Public Health is essential to disaster preparedness, mitigation, response, and recovery. This has never been more evident than during the COVID-19 pandemic when public health was the disaster response lead. However, students are graduating from accredited schools and colleges of public health with limited or no education in disaster management. This is a crisis unto itself, and it is incumbent upon The Council on Education for Public Health (CEPH) to take immediate action. Public health preparedness should be recognized as a core element in public health curricula, and practical experiences, such as drills and simulations, are necessary to equip students with the confidence and competencies needed in high-stress situations. The need for such preparedness education extends beyond the COVID-19 pandemic. It is a crucial step for creating a resilient and competent public health workforce capable of safeguarding community health in the face of complex and emerging challenges.

Objective: Disasters are the consequences of natural or technological hazards that affect a vulnerable society.¹ Technological disasters are divided into three groups: industrial, transport, and miscellaneous.^2,3 It is possible to determine the risks of technological disasters, to determine priorities, and to plan services by knowing this epidemiology.⁴ In this study, we aimed to define the distribution and characteristics of the subtypes of technological disasters in the world according to regions and years.

Methods: Our study was conducted using the international dataset at www.emdat.be/. The technological disasters between 1970 and 2020, the years they occurred, their locations (region and continent), the types of disasters, and the numbers of dead and affected were recorded.

Results: We found that the greatest number of disasters occurred between 2001 and 2010. The most common type of disaster was transportation accidents. While the continent with the most frequent disasters was Asia (3 879 [45.6%]), it was followed by Africa (2 220 [26.1%]) and South and North America (1 359 [16%]).

Conclusions: Transport accidents are the most common cause of technological disasters, and road accidents are the most common type of transport accident.

Objective: This study aims to compare the demographic, clinical characteristics, and outcomes of burn injuries in toddler and preschool children, and to validate the American Burn Association (ABA) Burn Triage Decision Matrix in the Turkish pediatric population.

Methods: A retrospective analysis was conducted on 684 pediatric burn patients (494 toddlers, 190 preschoolers) admitted to our burn center over a 5-year period. Variables including gender, burn etiology, burn area, depth, treatment modalities, complications, length of hospital stay, and mortality were analyzed. The performance of the ABA Burn Triage Decision Matrix was evaluated in both groups.

Results: Scalding was the predominant cause of burns in both groups, with a significant difference in the involvement of anterior trunk (p = 0.027). The mean Total Body Surface Area (TBSA) was comparable between the groups (p = 0.286). There was no significant difference in mortality rates (p = 0.385), treatment modalities, and complications. The ABA Burn Triage Decision Matrix demonstrated consistency in triaging the severity of burn injuries, with a notable discrepancy observed in the moderate risk category of toddler group.

Conclusions: This study highlights the distinct characteristics and outcomes of burn injuries in different pediatric age groups. The ABA Burn Triage Decision Matrix's validation suggests its utility in enhancing triage accuracy and resource allocation in pediatric populations, especially in disaster-prone regions.

Objective: Flood is one of the major public health concerns increasing the risk of childhood diarrhea. This study aims to explore the association of floods with diarrhea among under-five children in rural India.

Methods: A cross-sectional study was carried out using large-scale nationally representative data from the National Family Health Survey-5. The Central Water Commission reports between the years 2018 and 2020 were used to group all the districts as non-flood-affected districts or flood-affected districts. Bivariate and multivariate logistic regression models were employed to assess the association of floods with childhood diarrhea.

Results: The prevalence of diarrhea was higher among children exposed to three consecutive floods during the year 2019-21 than those children not exposed to flood. Children exposed to flood three times between the year 2018-19 to 2020-21 were associated with a 34% higher likelihood of developing diarrhea than those children exposed to flood one or two times.

Conclusions: Our study suggests that community health workers should target mothers belonging to the poor wealth quintile, young mothers, and mothers with young infants and more children to receive child health related counseling in flood-prone areas.

Objectives: In the field of cancer, many cancer patient associations (CPAs) have been established in Türkiye to support individuals living with cancer (ILCs) throughout the diagnosis and treatment processes. The presence of CPAs for ILCs became more significant after the major earthquakes in southeastern Türkiye in February 2023. The aim of this study is to identify the challenges of ILCs after the earthquakes from the perspective of CPA members.

Methods: This study employed a qualitative approach. The data collection method was in-depth interviews. Semi-structured, open-ended interviews were conducted with 15 volunteers who work with ILCs, selected through purposeful sampling. The data were analyzed by using inductive thematic analysis. This study was conducted between April and May 2023.

Results: Three main themes (problems of ILCs caused by earthquakes, access to health care, future concerns) and 11 subthemes were extracted through analyzing interviews.

Conclusion: ILCs experienced diverse difficulties after earthquakes. Members of CPAs observed that acute interventions to injured people and humanitarian aid activities had the first-place importance after the earthquake, while cancer-related care took the second place, anticipating devastating outcomes for the future of their care. CPAs should be supported by the public, local governments, and central government in their endeavors for ILCs.

Objective: This study assesses the collective community capacity of the National COVID-19 Resiliency Network (NCRN), a multisectoral network mitigating the disproportionate impact of COVID-19 on minoritized populations.

Methods: From January to April 2022, we used two concurrent data collection methods: a Collective Community Capacity (C3) survey (n=65) and key informant interviews (KIIs) (n=26). The C3 assessed capacity for creation of a shared vision, engagement in community change, and distributive leadership. KIIs assessed perspectives on network formation and implementation. We used a convergent design and triangulation for interpretation.

Results: NCRN has growing collective community capacity. The C3 survey found high capacity for establishing a shared mission and evidence of mutual commitment, trust, and accountability. About three-quarters of respondents strongly agreed that partners addressed social, economic, and cultural barriers related to COVID-19. Interviewees valued NCRN leaders' openness, availability, and willingness to listen. Partners learned from one another, increased their health communication capacity, and supported sustainability. They sought greater opportunities to partner and support decision-making.

Conclusions: NCRN developed a collaborative network with a shared vision of improving health equity during and beyond the COVID-19 pandemic, while identifying areas for improvement in distributive leadership. Findings can support other organizations seeking to build collective community capacity to address equity in public health emergencies.